Consumer-Directed Payer Data Exchange
- Release 0.1.0

This page is part of the CARIN Blue Button Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Turtle Format: ValueSet-CARIN-BB-Adjudication-Category

Raw ttl

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ValueSet;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "CARIN-BB-Adjudication-Category"];
  fhir:Resource.meta [
     fhir:Meta.versionId [ fhir:value "5" ];
     fhir:Meta.lastUpdated [ fhir:value "2019-11-30T09:17:00.000+00:00"^^xsd:dateTime ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CARIN Blue Button Claim Adjudication Category Value Set</h2><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html\"><code>http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-benefitPaymentStatusCode\">benefitPaymentStatusCode</a></td><td>Benefit payment status code</td><td>Benefit payment status code</td></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-paymentDenialCode\">paymentDenialCode</a></td><td>Payment denial code</td><td>Payment Denial Code</td></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-submittedamount\">submittedamount</a></td><td>submitted amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-allowedamount\">allowedamount</a></td><td>allowed amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-deductibleamount\">deductibleamount</a></td><td>deductible amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-coinsuranceamount\">coinsuranceamount</a></td><td>coinsurance amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-copayamount\">copayamount</a></td><td>copay amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-noncoveredamount\">noncoveredamount</a></td><td>noncovered amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-cobamount\">cobamount</a></td><td>cob amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-paymentamount\">paymentamount</a></td><td>payment amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-patientpayamount\">patientpayamount</a></td><td>patient pay amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-denialreason\">denialreason</a></td><td>payment denial reason</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-innetworkbenefitpaymentstatus\">innetworkbenefitpaymentstatus</a></td><td>in network benefit payment status</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-outofnetworkbenefitpaymentstatus\">outofnetworkbenefitpaymentstatus</a></td><td>out of network benefit payment status</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-otherbenefitpaymentstatus\">otherbenefitpaymentstatus</a></td><td>other benefit payment status</td><td/></tr></table></li></ul></div>"
  ];
  fhir:ValueSet.url [ fhir:value "http://hl7.org/fhir/us/carin/ValueSet/carin-bb-adjudicationcategory"];
  fhir:ValueSet.version [ fhir:value "0.1.0"];
  fhir:ValueSet.name [ fhir:value "CARINBBAdjudicationCategory"];
  fhir:ValueSet.title [ fhir:value "CARIN Blue Button Claim Adjudication Category Value Set"];
  fhir:ValueSet.status [ fhir:value "draft"];
  fhir:ValueSet.date [ fhir:value "2019-12-23T19:40:59+00:00"^^xsd:dateTime];
  fhir:ValueSet.compose [
     fhir:ValueSet.compose.include [
       fhir:index 0;
       fhir:ValueSet.compose.include.system [ fhir:value "http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory" ];
       fhir:ValueSet.compose.include.concept [
         fhir:index 0;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "benefitPaymentStatusCode" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "Benefit payment status code" ]       ], [
         fhir:index 1;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "paymentDenialCode" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "Payment denial code" ]       ], [
         fhir:index 2;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "submittedamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "submitted amount" ]       ], [
         fhir:index 3;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "allowedamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "allowed amount" ]       ], [
         fhir:index 4;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "deductibleamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "deductible amount" ]       ], [
         fhir:index 5;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "coinsuranceamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "coinsurance amount" ]       ], [
         fhir:index 6;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "copayamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "copay amount" ]       ], [
         fhir:index 7;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "noncoveredamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "noncovered amount" ]       ], [
         fhir:index 8;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "cobamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "cob amount" ]       ], [
         fhir:index 9;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "paymentamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "payment amount" ]       ], [
         fhir:index 10;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "patientpayamount" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "patient pay amount" ]       ], [
         fhir:index 11;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "denialreason" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "payment denial reason" ]       ], [
         fhir:index 12;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "innetworkbenefitpaymentstatus" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "in network benefit payment status" ]       ], [
         fhir:index 13;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "outofnetworkbenefitpaymentstatus" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "out of network benefit payment status" ]       ], [
         fhir:index 14;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "otherbenefitpaymentstatus" ];
         fhir:ValueSet.compose.include.concept.display [ fhir:value "other benefit payment status" ]       ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.